Jefferson Lake Emergency Physicians LLC

NPI #1649608795 in Madison, Indiana

Provider Information

NPI Number: 1649608795
Entity Type: Organization
Organization Name: Jefferson Lake Emergency Physicians LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Oct 29, 2013
Last Updated: Mar 30, 2023

Practice Location

Address: 1373 E STATE ROAD 62
City: Madison
State: Indiana
ZIP Code: 47250-7328
Phone: (812) 801-0800

Authorized Official

Name: KAREN VAUGHN
Title: OFFICER
Phone: (973) 251-1132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Emergency Medicine	207P00000X	Primary

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